First up, if you’re sick, you need to go to the doctor and follow all medically necessary advice to get well and protect others around you. I am not a medical professional. I am sharing what I’ve learned through all my years of experience both personally and professionally working to help athletes stay healthy during times of sickness and stress.
Keep in mind this article is meant to help healthy athletes stay healthy during a time of increased viral exposure. Everyone is different, some things will work for one person, other things for another. This is not a substitute for critical medical interventions. I personally have found that our medical system has both saved my life and utterly failed me. Thus, I believe in a combination of good self-care, alternative, supportive methodologies and medical interventions as needed.
Disclaimer aside, there are ways you can support your immune system to give you a better chance of staying well during both normal cold and flu season and our ‘new normal’ during the COVID-19 pandemic. These strategies can give you a measure of control and confidence in your new routine.
How does exercise impact your immune system?
The quick answer is that exercise strengthens your immune system and helps you stay healthy. Active people tend to get sick less often. Too much volume and/or intensity can decrease immune function leaving you more vulnerable to infection. How much is too much and what do we know and do? Does exercise increase your susceptibility to the Coronavirus?
Exercise exerts certain stresses on the body. Mostly good stresses, the kind that make you fitter, stronger, faster and healthier in a multitude of ways. Along with this stress response, our bodies release stress hormones such as cortisol and epinepherine. Inflammation increases and immunity decreases. But, these are all temporary conditions and none at a critical point as to cause any harm (unless you are run down or over training).
It’s the excess levels of stress hormones, especially cortisol, that wear you and your body down. Getting warn down or run down, leaves you more vulnerable to infection. Hence the need to train/recover/train/recover, repeat.
With long, hard training, the research is still ongoing. But, the best current research supports that the physiological, metabolic, and psychological stresses associated with high exercise training workloads and competition are linked to immune dysfunction, inflammation, oxidative stress and muscle damage. This can put triathletes at a higher risk for infection, especially upper respiratory infections. Keep in mind that these are temporary conditions; they are not permanent. And, taking steps to take care of your body after long hard training and competition will help support your fitness, recovery and immune system.
Here is what else we know about exercise and the immune system:
- Research indicates that immunity can be remodeled during the aging process as a result of exercise and interactions with the environment.
- Regular training reduces systemic inflammation. Decreased inflammation is associated with a strong, healthy immune system.
- Exercise diversifies the gut microbiome by increasing gut-immune system activity (approximately 60% of your immune system is in your gut).
- Exercise increases our production and circulation of white blood cells (WBCs – and other immune system markers) helping to combat disease. When WBCs circulate more rapidly during exercise, they may detect illnesses sooner. Physical activity increases blood and lymph circulation thus helping to flush bacteria out of the body, especially the lungs. Keeping your lungs clear and healthy reduces your chances of getting a cold or flu.
- During and after exercise, there is a brief rise in body temperature that may act in the same way a fever does to help your body fight infection better.
- Inflammation and immunity are closely related and both impacted by exercise both positively and negatively.
Anti-viral herbs and supplements
- Thyme tea, ginger tea or ginger water, herbal combination teas: gypsy cold care, throat coat, echinacea plus, medicinal mushrooms: reishi, shiitake, miatake, chaga.
- L-lysine, zinc (as liquid zinc sulfate), liquid B-12, vitamin D3 w/K2 , Vitamin C (Ester C or other C with citrus bioflavonoids), B vitamins.
- Cat’s claw, lemon balm, licorice root, spirulina, barley grass powder, mullein leaf, golden seal, elderberry syrup.
Essential oils. Alternative to hand sanitizer?
Have you heard of Thieves oil? The story goes that back to the Middle Ages during the black plague. Thieves would douse themselves with essential oils before entering infected homes to rob them. It was reported that they did not get sick. Thieves oil is a blend of various essential oils with antimicrobial properties: clove, lemon, cinnamon, eucalyptus and rosemary.
Researchers have looked into antimicrobial properties of several of these oils and concluded that they do kill various strains of virus, bacteria and fungus. (No word as to efficacy against the coronavirus.) The most effective oils are: cinnamon, eucalyptus, rosemary, clove, oregano and carrot seed. Various blends of these oils did prove to be antiviral, antibacterial and antifungal. The properties of the essential oils actually damage the toxic cells without any antibiotic resistance or harmful side effects. (Looks like those thieves were pretty smart.)
I have a diluted blend in a spray bottle that I use on surfaces I’m not able to clean: public places, bathrooms, my car after grocery shopping, package deliveries, etc. I use it everywhere I go. I spray on my hands like hand sanitizer.
Foods that boost your immune system
Consume a well-balanced diet with sufficient energy to maintain a healthy weight, with a focus on grains, fruits, and vegetables to provide sufficient carbohydrate and polyphenols that reduce exercise-induced inflammation and improve viral protection.
Carbohydrates are key to good health and to support regular exercise. Glucose and glycogen are at the center of healthy immunity and are key to good fueling of workouts and recovery. When you ingest carbohydrates during exercise, your serum glucose increases, stress hormones decrease (cortisol, epinepherine), and inflammation decreases. Your immune cells actually need glycogen to stay healthy. After a 3 hour run, they actually “bonk”. They become glycogen depleted and are weakened by the workout or race. But, by consuming carbohydrates during this long run, your immune cells actually perform better.
Here are some foods that are anti-viral, anti-inflammatory and strengthen your immune system.
Healing broth recipe. honey, fruit: especially blueberries (high levels of polyphenols), berries and citrus. 1 cup a day of blueberries can dramatically decrease your anti-inflammatory response (Try wild blueberries for an even greater anti-oxidant boost.)
Raw garlic, spinach, turmeric/ginger shots, oranges, tangerines, Clementines, grapefruit, lemon, lime papaya, kale, asparagus, sweet potatoes; white potatoes, celery juice, cucumber juice, lemon or lime water, parsley, cilantro, lettuce, red skinned apples, bananas, artichokes, pears, green beans, raw garlic; rosemary, sage thyme, basil.
Foods to avoid: eggs (they feed on viruses), dairy, excess fats (even the healthy ones).
Pay attention to refueling especially during a longer workout. Consuming a carbohydrate or carb/protein sports drink during your workout will minimize cortisol elevation and muscle protein breakdown.
Don’t skip your recovery nutrition. Consuming a carbohydrate/protein recovery drink or snack within 45 minutes post workout can pay dramatic dividends by reducing cortisol levels and minimize inflammation both factors which negatively impact your body’s defense mechanisms.
Maintain hydration levels before, during and after your workout. Dehydration increases the cortisol response. Drink a combination of plain water, sports drink, and healthy, fresh fruit and vegetable juices.
Get a good night’s sleep consistently. Sleep deprivation causes an increase in cortisol levels independent of exercise. Do your best to get 7-8 hours a night. Taking short naps are also helpful. Anytime your body can shut down and relax for a while gives it some time and space to repair and regenerate.
Feel like you’re run down? In the early stages of illness? The best thing you can do is shut down and get in bed. Cancel everything and sleep as much as you can. Sleep is one of the most important things we can do for our body’s defense mechanisms. This combined with supportive therapies give you and your immune system the best chance to kick an illness in its early stages.
For more information on sleep and performance, please check my blog on my website.
Keep the virus out of your lungs. Protect your respiratory system.
Viruses are passed on by breathing them in or touching an infected surface, then touching your face, nose, eyes, etc. We all need to protect our lungs, especially as athletes. The COVID-19 virus seems to do the most damage when it reaches the lungs: persistent cough, pneumonia and secondary infections in the lungs.
What can you do to help keep it out of your lungs? First, all the hand washing, clothing washing, don’t touch your face, etc. advice applies to us all. As active athletic people, we are not immune to this virus!
Do your best to keep your nasal passages and sinuses clear, clean and healthy. Keeping it out of there, lessens the risk to your lungs.
Keep your sinuses moist with saline sprays and sinus rinses. Germs are less likely to “stick” when kept moist and flushed out regularly. Adding a drop or two of Sovereign Silver may also help to clear out any microbes hiding in there.
If you’re worried about your lungs, talk to your doctor about this and the possibility of getting a pneumonia vaccine.
Should I workout or not workout if I’m sick? How much is good? How to maximize your immunity and keep training
Your short-term immune response to exercise depends on the duration and intensity of effort. The accepted dividing line between hard/long and short/easier exercise is 60 minutes and 60% of VO2 max or 75% of max heart rate. This intensity translates to the upper end of your aerobic endurance range. Everyone is different, your years of training and other outside stressors may determine what your body can and cannot handle.
60 minutes of moderate exercise is immune boosting, i.e. workouts with hard intervals less than 60 minutes total. Pro-inflammatory processes and stress hormones do not reach high enough levels to be harmful when the workout is under 60 minutes. The immune system gets stronger and, at this level, exercise is an anti-inflammatory activity.
Reduce the number of high volume, high-intensity workouts per week. If you do have a long or long/hard training day, avoid going out in public for 2 hours or more after these workouts. Give your body a chance to recover, refuel and get your immune system back online.
Take a rest day or very light training day after a particularly hard or long workout. This is a good practice even if there was no threat of coronavirus. Everyone is a little different as to what they can handle, so learn to understand what is best for you. (I am here to help!)
We all want to train and train hard for our next competition (or just to stay healthy and sane!). We all want to keep our immune systems robust and healthy especially during times of heightened psychological stress. The ultimate objective is to achieve your fitness and performance goals with little interruption from illness and fatigue. The best approach is to work to create a lifestyle that adapts and supports training, hygiene, nutrition, and psychological strategies.
Here are some strategies:
- Managing training loads. I am here to help with this! If you feel run down, rest is best. If you’re feeling stressed, rest or a workout may be best. Try the 15-minute rule. Start your workout, if you don’t feel better after 15 minutes, shut it down and relax.
- Monitor for early signs and symptoms of overtraining, feeling run down, chronic lack of sleep, etc. These can all contribute to making us more vulnerable to illness. Monitoring your morning heart rate or HRV can indicate signs of excess fatigue or stress.
- Avoid hard training if you are sick.
- Avoid excess alcohol intake.
- Overall stress management is key. In times of high stress, it’s important to take care of your mental health. Yoga, meditation, breathing exercises, etc. can all help your immune system do its job.
- Develop coping strategies that minimize the internalized impact of negative life events and emotions (see below for more strategies).
Sunshine and fresh air
This one is my favorite because it’s so simple and available to all of us most of the time. Being out in the sun and fresh air is actually antimicrobial. Yes, “outside” kills germs.
During the Spanish flu pandemic of 1918, medics in Boston found that severely ill flu patients nursed outdoors recovered better than those treated inside. Medical staff observed that people who were in crowded places such as military barracks and troop ships at the end of WWI. Both were poorly ventilated places with people living in very close quarters. They began to erect ‘tent hospitals’ to take care of patients. In good weather, they were taken outside for fresh air and sunshine. It was a common practice in those days. This so-called ‘open air therapy’ was also used for wounded soldiers. This regimen remained popular until the widespread use of antibiotics replaced it in the 1950s
A combination of fresh air and sunshine cured the most severely sick patients, prevented deaths and prevented the spread of infection among medical staff. Research shows that outdoor air is a natural disinfectant. Fresh air can kill the flu virus and other harmful germs. And, sunlight is a germicidal that can kill the flu virus.
Mindset reset – Stryd interview with Olympic coach Bobby McGee
Work to actively decrease mental stress. Our thoughts and mental focus (self-talk) go a long way to either keeping us calm or agitated. Here are some tips to help you go with the flow in these ever-changing times, based on highlights from this YouTube interview:
See the OPPORTUNITIES:
- Reduced myopia – focus on what’s really important. Adversity offers opportunity. Actively look for those opportunities.
- Outside is a good option mentally too (see above).
- Taking responsibility to plan your individual process brings clarity & urgency – plan your individual focus, what do I need? Be proactive about what you need and what you can control.
- Creativity arises from coach and athlete collaboration. Here is an opportunity to be more creative and approach things a little differently. How can we improve your skill and fitness level?
- Renewed focus from the need to replace what may have become rote or habituated. Here’s an opportunity for fresh stimulus to jump-start fitness. Move in a slightly different direction, be more creative. Adaptation & super compensation.
- Mindfulness – meditation, limited media exposure, calming relaxing activities.
- Acceptance – acceptance is key, keep working at it. Be patient with the process.
- Patience – we are not in control of destiny, of race scheduling, but you are in control of many other things.
- Objectivity – sit back and see yourself as a science project. Deep breath, count to 10, consider options, choose a new plan, make good decisions.
- Associative vs dissociative thinking – focus on your skills and metrics in your shorter, harder workouts. Disconnect if long easy workout. Focus on external awareness. You are able to access more power and resources if you focus on associative thinking during workout.
- Intensity management – negative interest rate in endurance banking/pacing – going hard on your easy workouts, pays negative dividends. Hard on hard days, easy on easy days.
- Environmental stimuli – consciously change things up – change the direction of your bike trainer is pointing. Run your same outside route backwards.
We now have the opportunity to understand and focus on what is most important in our lives. Please keep your body moving!
References & Resources
Portman, Robert. Dr. Portman’s Performance Nutrition Tip of the Week. Email, 18 March 2020.
Medline Plus. Exercise and immunity. U.S. National Library of Medicine:
Burfoot, Amby. How to train and eat to boost your immunity from Coronavirus. Podium Runner online. 11 March 2020.
Grande A.J., Reid H., Thomas E.E., Nunan D., Foster C. Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults. Cochrane Database Syst Rev. 2016;22 CD011857.pub2.
Nieman, David. Wentz, Laurel. The compelling link between physical activity and the body’s defense system. Journal of Sport and Health Science. 2019 May; 8(3): 201-217.
Brochot, Amandine, et al. Antibacterial, antifungal, and antiviral effects of three essential oil blends. Microbiology Open. 2017 Aug, 6(4).
Hobday RA and Cason JW. The open-air treatment of pandemic influenza. Am J Public Health 2009;99 Suppl 2:S236–42. doi:10.2105/AJPH.2008.134627.
Aligne CA. Overcrowding and mortality during the influenza pandemic of 1918. Am J Public Health 2016 Apr;106(4):642–4.
Hobday, Richard. Coronavirus and the Sun: a Lesson from the 1918 Influenza Pandemic. medium.com 10 Mar 2020.
YouTube blog/interview between Stryd and Bobby McGee: 17 March 2020